Drug Testing Doctors

Greg House M.D. is a fictional character, a mastermind diagnostician with a vicious Vicodin addiction. During the series, we watched his slow transition from user to abuser, from clean to relapse, as he struggled with his demons and his pills.

In fact, physicians have about the same addiction rates, or slightly higher, than the general public. Overall about 10 percent of physicians have suffered through an addiction problem at one point in their careers.

Physicians Face Different Addiction Issues

There is a significant difference between the drugs of choice for doctors and non-doctors. Physicians abuse prescription drugs five times more than the lay public. One study found that 69 percent of physicians with an addiction problem chose prescriptions.

According to an NIH study, physicians’ addictions can often be more advanced than the general public before detection. The researchers write, “This delay in diagnosis relates to physicians’ tendency to protect their workplace performance and image well beyond the time when their life outside of work has deteriorated and become chaotic.”

Should we drug test doctors?

A recent poll shows public support for drug testing physicians. Currently, a few hospitals require drug testing, either upon hire or randomly during employment. Our own Sermo Physician Poll shows that only 35% percent of physicians support drug testing for their profession.

California is currently validating signatures for a ballot question voters will likely see this fall. The bill is modeled after Federal Aviation Administration drug testing policies and would require random drug testing with hospital privileges and testing after adverse events such as preventable death.

A trio of physicians wrote in JAMA this past year that drug testing should be mandatory, especially after sentinel events where a patient dies unexpectedly or suffers serious harm from medical treatment.

Is It the Right Thing To Do?

The physicians inside Sermo who were opposed to the idea stated privacy rights and the dire consequences physicians face if caught. They argued for compassion over punishment.

One surgeon said, “In every drug related case of impairment that I have seen in the last 35 years or been directly involved with, the professional who was having an issue gave obvious clues that were addressed by their colleagues or superiors prior to any patient harm.”

A family practitioner noted, “this seems to be a completely misguided ‘solution’ to a problem that may be real, but has a lot of other, and more effective, potential solutions.”

The ACLU opposes any drug testing citing high program costs, inaccuracy of tests, and privacy issues.

What do you think? Should we test physicians and other health care practitioners (HCPs)? If not, why should HCPs be exempt from drug testing? This topic has generated a lot of conversation inside Sermo, if you’re an M.D. or D.O. please join us inside.